Finding a new normal

I had my St. Jude dual lead pacemaker implanted in mid November. Having recovered quickly from previous Prostate Cancer surgery and 33 Radiation treatments, I expected to return to fitness quickly once I was allowed to resume exercise. I find that recovering from a hard workout, such as swim, spin or run, is much harder than I have ever experienced. I'm 66, have always been fit. It now takes hours to recover when it used to take minutes.

Anyone have any perspective on this?

5 Comments

recovery

by Tracey_E - 2014-02-05 04:02:10

Why did you get the pm? What happens when you exercise- dizzy, prematurely tired, etc?

How long were you sick overall? A new heart condition and fighting cancer are a lot for a body to process, it's not going to bounce back overnight.

What else is going on?

by Theknotguy - 2014-02-05 07:02:15

What else is going on? Do you have a-fib? Did you have an ablation? Anything else?

Because of the amount of trauma I had before I got the PM, I've had a harder time in rehab than I'd like. I've got more angina than I'd like and things are moving slower.

However I've been working through it and am able to bring up my exercise level before getting angina. It's just that it takes time. I was making great progress, went into an a-fib session, and had the rehab nurse throw me into the ER. That little trip cost me a week and a half as far as the exercise regimen goes.

The day before my collapse I moved 2000 pounds of wood. The day of my collapse I walked 3 1/2 miles. Then woke up in the hospital six days later. You'd think I'd jump right back - your logical brain tells you that. But it doesn't work that way.

I rely on the expertise of the cardiac rehab nurses. As long as they tell me I'm doing OK I just keep plugging along. I try not to get frustrated.

Hang in there.

Theknotguy

Thanks

by TJ319 - 2014-02-05 09:02:06

Thanks for the comments.

I got the PM because my cardiologist was concerned about low hr (35 at rest, in the 20's when asleep) and 2nd degree AV block.. My cardiologist had been predicting the need for a PM for about 10 years during annual visits. I did not feel bad at all and had been on a nice recovery path after the surgery and radiation. However, the cardiologist ordered a 48 hour halter monitor test and, following that, insisted that the PM go in. What disappoints me is how much "worse" I feel after exercise compared to pre PM. Now I get very tired. Sometimes my HR cycles rapidly between 60, the low set point, and 102 for hours after a hard spinning or running session. Also, I sometimes have a tightness in my chest after exercising for an hour or two. None of this ever happened before the PM. My doc did say I have to take it slower.

treadmill

by Tracey_E - 2014-02-05 11:02:35

Ask your dr to put you on a treadmill while on the pm computer so they can see exactly what happens when you work out. AV block is a very simple fix so it really shouldn't affect your ability to exercise if it's programmed properly. Problem is, most drs don't have a lot of pm patients who run so they aren't great at getting the settings where they need to be.

Theoretically it's a simple fix. The atria beats, the ventricle does not, the pm paces the ventricle and completes the broken circuit. The pm will only pace to a maximum set rate. So if your max rate is 120 but your atria is doing 150, you're going to feel like crud because the heart will be out of sync. Some pm's have a feature called rate response. It's there to help people with sinus issues get their rate up when the heart doesn't do it on its own. With av block, we don't need this but sometimes they turn it on. It shouldn't make a difference but it can compete with our natural rate. There are some other things that can be tweaked, also. Ten minutes on the treadmill can save a lot of time with trial and error.

BTDT - No Fun at all!

by donr - 2014-02-06 08:02:14

TJ: As you describe it, you had the PM installed RIGHT BEHIND the other procedures.

I was diagnosed w/ PC in Oct 2003 after a PM being installed in the previous Feb. I, however, had no surgery, but went through 45 radiation treatments. That radiation takes a real toll on the body in subtle ways.

I assume that you had what is called IMRT, a highly focused radiation pattern that really hits no vital organs to affect them for a long term - just as I did. My oncologist showed me the radiation pattern & how much area it affected outside the prostate itself. There was almost nothing in the path of the beam that would even suggest that it was a vital organ involved in routine daily living. Yet, by the THIRD session, I was feeling like roadkill on an interstate highway. MOF, I had a lot of the same side effects as the women undergoing treatment for a uterine tumor that was higher & involved a lot of intestinal area.

My after effects lasted some 3 months post treatment that was noticeable & really about nine months of subtle effects.

Now I realize that the PM procedure was better than 18 inches up the body & several months later, but add that into the mix of incomplete recovery from the radiation in a way that you may not have realized at the time, & you could have some issues jumping up to bite you in this recovery that are unpleasant.

F'rinstance - fatigue, nausea following very localized radiation exposure away from the massive area of the torso of the body. No obvious exposure of large bones & their marrow - that should not affect red cell production. My oncologist could not explain why those side effects happened, but they did. There are some radiation aftereffects that crop up months post treatment, & that may well be your case.

I can give you two other confusing factors - your age - 66. You just don't recover as fast as you did when younger . The second factor - perhaps your PM needs some tweaking of its parameters. That is not at all unusual post-op.

You have a complicated situation at hand. Start by backing off in the intensity of your workout. Mainly because THAT is the first thing that all the medical pros will zero in on. Back down to essentially a mild effort & see how that flies. You have to show evidence that workout level is NOT the cause or you will never win any satisfaction. Unless you are training for a "Seniors" athletic event, you have the rest of your life to find out the cause.

Don

You know you're wired when...

Your favorite poem is “Ode to a Cardiac Node”.

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